Upload
amin-saleem
View
229
Download
0
Embed Size (px)
Citation preview
7/31/2019 Autoimmunity Final
1/31
7/31/2019 Autoimmunity Final
2/31
OBJECTIVES
DEFINITION
TOLERANCE
FACTORS OF AUTOIMMUNITY
MECHANISMS OF AUTOIMMUNITY
CLASSIFICATION OF
AUTOIMMUNEDISEASES
7/31/2019 Autoimmunity Final
3/31
7/31/2019 Autoimmunity Final
4/31
7/31/2019 Autoimmunity Final
5/31
Autoimmunity
Basically meansimmunity to self
A condition thatoccurs when theimmune systemmistakenly attacksand destroyshealthy body tissue.
7/31/2019 Autoimmunity Final
6/31
Genes and Autoimmunity
The concept that a single gene mutationleads to a single autoimmune disease isthe EXCEPTION not the rule.
Because of this autoimmune diseasesare generally classified as complex
diseases as there is not a singlepinpoint-able gene
7/31/2019 Autoimmunity Final
7/31
Many autoimmune diseases are associated with
certain HLA types and with gender
7/31/2019 Autoimmunity Final
8/31
Hormones
Females are much more likely to developautoimmune illness
Rise in hormones associated withpregnancy supports the idea
Hypothesis: estrogen responseelements (EREs) in several
genes
7/31/2019 Autoimmunity Final
9/31
Estrogens and Autoimmunity
7/31/2019 Autoimmunity Final
10/31
Nature Immunology 2, 777 - 780 (2001)
Sex differences in autoimmunity
7/31/2019 Autoimmunity Final
11/31
ENVIRONMENTAL FACTORS
Environmental factors elicit autoimmune diseasesby:
1-molecular mimic theory
2-tissue injury releases intracellular antigens thatelicit immune response
7/31/2019 Autoimmunity Final
12/31
Factors influencing autoimmune disease
Internal triggering
factors
genotype / HLA
cytokines
apoptosis genes
ID (IgA, CID, CVID,WA, C1,2,4),
hormones
External triggering
factors
infections
UV
drugs
chemicals (includingfood)
stress
7/31/2019 Autoimmunity Final
13/31
MOLECULAR MIMICRYALTERATION OF NORMALPROTEINSRELEASE OF SEQUESTERED
ANTIGENSEPITOPE SPREADING
7/31/2019 Autoimmunity Final
14/31
Rheumatic fever
is a classicexample ofmolecularmimicry
7/31/2019 Autoimmunity Final
15/31
Pick an organ, any organ . . .Autoimmunity can affect ANY organ/organ system in the human body
Pemphigus
Multiple Sclerosis
Sjogrens Syndrome
Rheumatic Fever
Autoimmune Hepatitis
Ulcerative Colitis
Goodpastures Syndrome
Diabetes
Autoimmune Uveitis
Autoimmune hemolytic Anemia
Addisons Disease
Rheumatoid Arthritis
Autoimmune Oophoritis
7/31/2019 Autoimmunity Final
16/31
7/31/2019 Autoimmunity Final
17/31
Multiple Sclerosis
MS patients can have autoantibodies and/or self reactive T cells
which are responsible for the demyelination of white matter of brain
7/31/2019 Autoimmunity Final
18/31
DIABETES :
Auto destructive T cells destroy the islets
cells of pancreas
The main antigen against which t cells
attack is directed is the islet cell enzyme,Glutamic acid decarboxylase
7/31/2019 Autoimmunity Final
19/31
Diabetes
G di
7/31/2019 Autoimmunity Final
20/31
Graves disease(anti-thyroid stimulating hormonereceptor; anti-TSHR)
In Graves disease, the antibodiesdo not destroy the thyroid but actas if they are TSH (i.e., they bindand activate the TSH receptor)(agonist)
(compare this to theHashimotos thyroiditis;
previous slide)
Normal
7/31/2019 Autoimmunity Final
21/31
7/31/2019 Autoimmunity Final
22/31
Autoimmune hemolytic anemia
7/31/2019 Autoimmunity Final
23/31
7/31/2019 Autoimmunity Final
24/31
l f i
7/31/2019 Autoimmunity Final
25/31
Examples of Systemic
Autoimmunity
SLE
7/31/2019 Autoimmunity Final
26/31
7/31/2019 Autoimmunity Final
27/31
Autoantibodies are formedagainst igG
Synovial memb infiltrated
With t cells,plasmacells,macrophages
Clinical finding is inflammation ofjoints of hands and feet
Treatment isNSAIDS,immunosuppressive
drugs,corticosteroids
Rheumatoidarthritis
7/31/2019 Autoimmunity Final
28/31
GOODPASTEURSSYNDROME
7/31/2019 Autoimmunity Final
29/31
Auto antibodies are formed
against collagen in basementmembranes of kidneys and lungs
Clinical findings
Hematurea
Proteinurea
Pulmonary hemorrhage
Cytotoxic antibodies activatecomplement c5a released
neurtophils enzymes destroy lungand kidney tissue
Treatment include
Plasma exchange toremove antibodies
Immunosuppresive drugs
Goodpasteurssyndrome
7/31/2019 Autoimmunity Final
30/31
REFERENCES
LEVINSON MEDICAL MICROBIOLOGY ANDIMMUNOLOGY
ROBBINS AND KUMAR
WWW.GOOGLE.COM FOR PICTURES
http://www.google.com/http://www.google.com/7/31/2019 Autoimmunity Final
31/31